View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0638
ICR Reference No:
200712-0920-006
Status:
Historical Active
Previous ICR Reference No:
200402-0920-007
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Follow-up Study of Chronic Fatigue Syndrome in Georgia (Survey of Chronic Fatigue Syndrome & Chronic Unwellness in Georgia-Baseline Survey)
Type of Information Collection:
Reinstatement with change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/30/2008
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/18/2007
Terms of Clearance:
Approved consistent with CDC revisions outlined in Agency memo. CDC has agreed that the results of the survey are not generalizable and will not be used to generate prevalence/cost estimates associated with CFS at either the state or national level.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2011
36 Months From Approved
Responses
2,870
0
0
Time Burden (Hours)
861
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
The Survey of Chronic Fatigue Syndrome and Chronic Unwellness in Georgia (Baseline Survey), conducted between 2004 and 2005, provided baseline information on CFS in metropolitan, urban, and rural regions of Georgia. Our Follow-up Study addresses the need to determine factors that are associated with improvement in clinical course, in order to decrease the morbidity (burden) of this illness. The goal of the Follow-up Study is to build on the Baseline Survey and identify risk factors for and biomarkers of CFS morbidity by evaluating changes in clinical parameters of CFS over the interval since the Baseline Survey.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: The Public Health and Welfare
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
71 FR 62473
10/25/2006
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 65735
11/23/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Follow-up Study of Chronic Fatigue Syndrome in Georgia (Survey of Chronic Fatigue Syndrome & Chronic Unwellness in Georgia-Base Line Survey)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
2,870
0
0
2,870
0
0
Annual Time Burden (Hours)
861
0
0
861
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The goal of the Follow-up Study is to build on the Baseline Survey and identify risk factors for and biomarkers of CFS morbidity by evaluating changes in clinical parameters of CFS over the interval since the Baseline Survey.
Annual Cost to Federal Government:
$320,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Maryam Daneshvar 4046394604
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
12/17/2007
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